The Budget Deal: An Okay End to a Very Bad Year for Medical Research

Congress's spending bill offers some relief to the National Institutes of Health, but Francis Collins says lawmakers are still scrimping on essential science.
President Obama chats with (from left) Dr. Francis Collins, Dr. Marston Linehan, and Secretary of Health and Human Services Kathleen Sebelius at the National Institutes of Health. (Kevin Lamarque/Reuters)

Two-thousand thirteen will go down as one of the least predictable—and most political—years in history for American medical research.

In the spring, sequestration—across-the-board budget cuts—wiped out more than 5 percent of fiscal-year 2013 budgets of government agencies that fund research and development, with the promise of more cuts over the next decade. The 16-day government shutdown in October wreaked further havoc, as scientists were told to put their work on hold while Congress got its act together. Now, nearing the end of a roller-coaster year, legislators are providing some relief (albeit with a side of whiplash) by swiftly passing a budget deal that heads off another shutdown and reverses many of the impending mandatory budget cuts.

At the National Institutes of Health, the largest provider of federal research money to universities and labs across the country, Director Francis Collins says it has been his most challenging year since taking the post in 2009, describing it as a “paradox.”

“In terms of scientific progress, 2013 has outstripped my expectations,” Collins said. “But in terms of a continued downward spiral of support it has been much worse than I thought it would be at the beginning of the year.”

Given that the NIH’s mission—fighting human disease and prolonging life—not only engenders widespread bipartisan support but also is widely viewed as a major economic engine and job creator, one might expect it to be shielded from appropriators’ red pen. Yet the government closure was the latest blow for NIH, which lost $1.71 billion during sequestration and has seen a 25 percent reduction in overall funding since 2003.

“During the shutdown I got tears in my eyes walking through labs where all the lights were off and the benches were empty,” Collins said. “Just a week before all kinds of great science had been going on and then, because of political stalemate, none of that was allowed to happen.”

But the NIH wasn’t just a passive victim—it became a central player in the shutdown. Reports revealed that the closure was preventing 200 patients, including 30 children, from being admitted to the NIH Clinical Center, often the last hope for people with rare diseases and incurable cancers. With Republicans bearing the brunt of public blame for the shutdown, House Majority Leader Eric Cantor pushed a bill to reopen NIH during the shutdown, daring Democrats and President Obama to be seen as opposing assistance for children with cancer.

If there was an upside to getting caught in the middle of a political boxing match, it was the boost in public recognition of NIH’s importance.

“NIH became the poster child of the government shutdown in a lot of ways,” said Carrie Wolinetz, president of United for Medical Research, a coalition of universities and advocacy groups. “But a very positive poster child in that it just highlighted what was already a pretty strong level of bipartisan support in Congress for this very critical agency.”

Prior to the shutdown, Collins felt NIH’s “brand was not seen as important as it should be.”

“If there was a tiny silver lining in the shutdown it was that NIH was seen as one of the harmed government agencies that people were most troubled by,” Collins said. “No matter what you think politically, the idea that a kid with a bad disease is being turned away from a research trial at the Clinical Center is not something you wanna look at and say 'well, it doesn’t matter.' So we got a bit of a bump in visibility but I don’t advocate that it was worth it.”

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Mark Micheli is the editor of Excellence in Government Online and a special-projects editor for Government Executive Media Group. He also contributes to GovExec, NextGov, and Defense One

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